Clinical Services Renewal (CSR) is LHSC’s proactive approach to the funding and service delivery transformation being implemented in Ontario’s health-care system by the Ministry of Health and Long-Term Care. LHSC supports the need for this system transformation in order to build a stronger and more sustainable model and, as health-care leaders with a legacy of innovation, aims to help define that future by renewing our clinical services.
Through three focused work streams encompassed by CSR, LHSC is working with all of our system stakeholders – including external partners as well as our patients and families – to drive change across the health-care continuum.
Following a well-defined process of development and thorough system of review and evaluation, more than 400 staff and physicians informed and developed the Clinical Strategy recommendations and resulting plan. The goals of this plan are to create a nimbler and result-oriented hospital environment with stronger levels of accountability and a culture of continuous improvement.
The plan centres around a new transformational model for LHSC that is focused on changing the way we deliver clinical services as a hospital over the next five years. The first phase will focus on 11 initiatives to be implemented over two years (with ongoing continuous improvement thereafter) and the second phase will focus on aspirational strategies that will advance and enhance specific clinical services.
Of the 11 phase one initiatives, some of the most high-profile work over the past year has been on the Emergency Department (ED) System Transformation project, which aims to improve the quality of the patient and provider experience in the ED by reducing wait times and streamlining the system.
The work involved in LHSC’s Clinical Strategy will drive the transformation needed for sustained organization excellence and strengthened partnerships with our community and regional health-care providers to enhance the continuum of care, health outcomes and patient experiences.
The work focuses on key areas at LHSC with high intensity and/or high complexity where improvements can be tested, monitored, and evaluated. Beginning with LHSC’s perioperative care, which was divided into three main areas (pre-admission clinics, sterile processing department and supply chain, and day of surgery), each area is responsible for developing recommendations and implementation.
Using process improvement methodology, each of the above areas formed working groups which included frontline staff, physicians, leaders and patients. Each group has conducted a thorough assessment of the current state – mapping all processes, resources and workflow, and within the context of the five dimensions of quality, identified where there are opportunities to create process efficiencies, better use of resources and streamline workflow. The resulting recommendations are currently in varying stages of approval and implementation.
The work under Partnering in Transformation largely falls under three main categories:
Work in all of these areas includes developing strategies that will lower the demand on hospital services, improving management of these patient populations while they are in-hospital, as well as ensuring the appropriate level of support when they are discharged. LHSC will investigate how we can ensure this patient population receives the best care when they enter the hospital system, and will work with key partners and stakeholders in the community to determine how this patient population can best utilize these resources to support their return to the community and avoid unnecessary re-hospitalization.
Ultimately, the work undertaken in Partnering in Transformation will create greater integration of services across the health care system. It will ensure that patients will receive the right level of support, at the right time, in the right care setting – whether that be acute, ambulatory, primary, or community-based.